scholarly journals Negative Impact of Wound Complications on Oncologic Outcome of Soft Tissue Sarcomas of the Chest Wall

Cancers ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 101 ◽  
Author(s):  
Mehran Dadras ◽  
Pascal Koepp ◽  
Johannes Maximilian Wagner ◽  
Christoph Wallner ◽  
Maxi Sacher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Soft Tissue ◽  
Chest Wall ◽  
Negative Impact ◽  
Soft Tissue Sarcomas ◽  
Operation Time ◽  
Surgical Margins ◽  
Wound Complications ◽  
Free Survival

A link of complications with worse oncologic prognosis has been established for multiple malignancies, while the limited literature on soft-tissue sarcomas is inconclusive. The aim of this study was to examine risk factors and the oncologic impact of wound complications after curative resection of primary soft-tissue sarcomas of the chest wall. Patients with primary soft tissue sarcomas of the chest wall were identified. Groups with and without wound complications were compared by using univariate and multivariate analysis to identify risk factors. For patients with clear surgical margins (R0), univariate and multivariate analysis of factors associated with 5-year local recurrence free survival (LRFS), metastasis free survival (MFS), and disease specific survival (DSS) were performed. A total of 102 patients were included in the study. Wound complications occurred in 11 patients (10.8%) within 90 days. Cardiovascular morbidity and operation time represented independent risk factors for wound complications. In 94 patients with clear surgical margins, those with wound complications had an estimated 5-year LRFS of 30% versus 72.6% and a 5-year DSS of 58.3% versus 82.1%. Wound complications could be identified as an independent predictor for worse LRFS and DSS. Patients with a high risk of wound complications should be identified and strategies implemented to reduce surgical complications and possibly improve oncologic prognosis.

Risk factor for wound complications following wide resection of soft tissue sarcoma in the adductor compartment of the thigh

2019 ◽  
Vol 49 (10) ◽  
pp. 932-937 ◽  
Author(s):  
Munehisa Kito ◽  
Keisuke Ae ◽  
Hirotaka Koyanagi ◽  
Tabu Gokita ◽  
Hideto Furuoka ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Soft Tissue ◽  
Femoral Artery ◽  
Univariate Analysis ◽  
Operation Time ◽  
Wide Resection ◽  
Wound Complications ◽  
Tumor Diameter ◽  
Intraoperative Bleeding ◽  
Maximum Tumor Diameter

Abstract Background The purpose of this study was to investigate deep-seated soft tissue sarcoma (STS) occurring in the adductor compartment of the thigh that underwent wide resection and to clarify the high-risk group for wound complications. Patients and methods From 2000 to 2017, we reviewed 104 cases of deep-seated STS occurring in the adductor compartment of the thigh that were treated at four specialized facilities with expertise in sarcoma treatment. Results Wound complications occurred in 40 cases (38.5%), of which 23 cases (22.1%) were cases with major wound complications (MWC). In univariate analysis, BMI (P < 0.01), maximum tumor diameter (P < 0.01), operation time (P < 0.01), amount of intraoperative bleeding (P < 0.01), and intraoperative intervention to the femoral artery and vein (P < 0.01) were significantly associated with wound complications. In multivariate analysis, the associated parameters were BMI (P < 0.01), maximum tumor diameter (P = 0.02), and intraoperative intervention to the femoral artery and vein (P = 0.01). When limited to cases with MWC, univariate analysis showed that maximum tumor diameter (P < 0.01), diabetes mellitus (P = 0.03), operation time (P < 0.01), amount of intraoperative bleeding (P < 0.01), and intraoperative intervention to the femoral artery and vein (P = 0.02) were significantly associated parameters. In multivariate analysis, maximum tumor diameter (P = 0.02) and amount of intraoperative bleeding (P = 0.04) were associated parameters. Conclusions For patients with risk factors for wound complications, control of bleeding are crucial when resecting deep-seated STS in the adductor compartment of the thigh. In cases with large tumors, surgeons should be especially cautious of cases requiring interventions that surround the femoral artery and vein in order to attain an appropriate surgical margin.

Postoperative Wound Complications after Internal Fixation of Closed Calcaneal Fractures: A Retrospective Analysis of 126 Consecutive Patients with 148 Fractures

2005 ◽  
Vol 94 (3) ◽  
pp. 243-245 ◽  
Author(s):  
A. Koski ◽  
H. Kuokkanen ◽  
E. Tukiainen
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Internal Fixation ◽  
Retrospective Analysis ◽  
Operation Time ◽  
Wound Complications ◽  
Calcaneal Fractures ◽  
Soft Tissue Complication ◽  
Closed Fractures

Aim: The aim of the study was to analyse the number of soft-tissue complications after internal fixation of calcaneal fractures and to evaluate risk factors leading to these complications. Material: A retrospective analysis of 126 consecutive patients with 148 operatively treated calcaneal fractures was performed. Only primarily closed fractures were included in the study. Results: Wound healing was problematic in 35 cases (24 per cent). The wound was infected in 23 cases (16 per cent) and a wound edge necrosis was observed in 12 cases (8 per cent). The soft tissue complication needed operative treatment in 20 cases (14 per cent). The complications did not lead to amputations in any case. In the end of the follow up all wounds had healed. Conclusions: The statistical analysis identified a longer delay in surgery and longer operation time to be positive risk factors for wound complications.

scholarly journals Risk Factors for Significant Wound Complications Following Wide Resection of Extremity Soft Tissue Sarcomas

2013 ◽  
Vol 471 (11) ◽  
pp. 3612-3617 ◽  
Author(s):  
Adam Schwartz ◽  
Alanna Rebecca ◽  
Anthony Smith ◽  
William Casey ◽  
Jonathan Ashman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
Wide Resection ◽  
Wound Complications

scholarly journals A Novel Four-Gene Prognostic Signature for Prediction of Survival in Patients with Soft Tissue Sarcoma

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5837
Author(s):  
Changwu Wu ◽  
Siming Gong ◽  
Georg Osterhoff ◽  
Nikolas Schopow
Keyword(s):  
Soft Tissue ◽  
Risk Score ◽  
Cox Regression ◽  
Soft Tissue Sarcomas ◽  
Gene Signature ◽  
Gene Set Enrichment Analysis ◽  
The Cancer Genome Atlas ◽  
Prognostic Models ◽  
Malignant Tumours ◽  
Free Survival

Soft tissue sarcomas (STS), a group of rare malignant tumours with high tissue heterogeneity, still lack effective clinical stratification and prognostic models. Therefore, we conducted this study to establish a reliable prognostic gene signature. Using 189 STS patients’ data from The Cancer Genome Atlas database, a four-gene signature including DHRS3, JRK, TARDBP and TTC3 was established. A risk score based on this gene signature was able to divide STS patients into a low-risk and a high-risk group. The latter had significantly worse overall survival (OS) and relapse free survival (RFS), and Cox regression analyses showed that the risk score is an independent prognostic factor. Nomograms containing the four-gene signature have also been established and have been verified through calibration curves. In addition, the predictive ability of this four-gene signature for STS metastasis free survival was verified in an independent cohort (309 STS patients from the Gene Expression Omnibus database). Finally, Gene Set Enrichment Analysis indicated that the four-gene signature may be related to some pathways associated with tumorigenesis, growth, and metastasis. In conclusion, our study establishes a novel four-gene signature and clinically feasible nomograms to predict the OS and RFS. This can help personalized treatment decisions, long-term patient management, and possible future development of targeted therapy.

Sarcomas of soft tissue and bone

2019 ◽  
pp. 454-467
Author(s):  
James Wylie
Keyword(s):  
Soft Tissue ◽  
Chest Wall ◽  
Palliative Treatment ◽  
Soft Tissue Sarcomas ◽  
Dose Fractionation ◽  
Target Definition ◽  
Patient Preparation ◽  
Radiotherapy Techniques ◽  
Hands And Feet

Chapter 20 covers sarcomas of soft tissue and bone and includes discussion of radiotherapy for soft tissue sarcomas (including indications for radiotherapy, essential investigations for planning radiotherapy, patient preparation, planning imaging required for target definition, target definition, dose fractionation, and critical organs and tolerance doses,including the sites forearm, hands and feet, retroperitoneum, chest wall, and spinal/para-spinal), particular histologies (angiosarcoma and fibromatosis), particular radiotherapy techniques, and palliative treatment (including cerebral and lung secondaries),

Correlation of Soft Tissue Swelling and Timing to Surgery With Acute Wound Complications for Operatively Treated Ankle and Other Lower Extremity Fractures

2019 ◽  
Vol 40 (5) ◽  
pp. 526-536 ◽  
Author(s):  
Matthew D. Riedel ◽  
Amber Parker ◽  
Mingxin Zheng ◽  
Jorge Briceno ◽  
Steven J. Staffa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Lower Extremity ◽  
Tobacco Use ◽  
Wound Complication ◽  
Timing Of Surgery ◽  
Ankle Fractures ◽  
Patient Specific ◽  
Wound Complications ◽  
Heel Pad

Background: Considerable debate exists regarding how soft-tissue edema should influence timing of surgery for ankle and other lower extremity fractures. Assessment of swelling is subjective, and timing varies among surgeons. However, timing of surgery is one of the few modifiable factors in fracture care. Ultrasonography can objectively measure swelling and help determine optimal timing. The purposes of this study were to determine whether objective measures of swelling, timing to surgery, and patient-specific risk factors correlated with wound complications and to try to create a prediction model for postoperative wound complications based on identified modifiable and nonmodifiable risk factors. Methods: Patients with closed ankle and other lower extremity fractures requiring surgery with an uninjured, contralateral extremity were included. Demographic information and sonographic measurements on both lower extremities were obtained pre-operatively. Subjects were followed for 3 months and wound complications were documented. A predictive algorithm of independent risk factors was constructed, determining wound complication risk. Given that patients with ankle fractures made up the majority of the study cohort (75/93 or 80%), a separate statistical analysis was performed on this group. A total of 93 subjects completed the study, with 75/93 sustaining ankle fractures. Results: Overall wound complication rate was 18.3%. Timing to surgery showed no correlation with wound complications. A heel-pad edema index >1.4 was independently associated with wound complications. Subgroup analysis of ankle fractures demonstrated a 3.4× increase in wound complications with a heel-pad edema index >1.4. Tobacco history and BMI >25 were independent predictors of wound complications. An algorithm was established based on heel-pad edema index, BMI >25, and tobacco history. Patients with none of the 3 factors had a 3% probability of a wound complication. Patients with 1/3, 2/3 and 3/3 factors had a 12-36%, 60-86% and 96% probability of a wound complication, respectively. Conclusions: Timing to surgery had no correlation with wound complications. Heel-pad edema index >1.4, BMI >25, and tobacco-use correlated with wound complications. When separately analyzing the cohort that sustained ankle fractures, the heel-pad edema index of >1.4 was still demonstrated to be predictive of wound complications corresponding to a 3.4× increase in wound complication rates (11.1% vs 37.5%). Risk of wound complications significantly increased with each factor. In patients with increased BMI and/or tobacco use, resolution of heel edema may significantly reduce wound complications in lower extremity trauma. Level of Evidence: Level II, prognostic, prospective cohort study.

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